Patient Pain

Question 1

What is pain?

Answer 1

an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

Question 2

acute pain

Answer 2

intense, but time limited
result of tissue damage or disease
disappears as injury heals
lasts less than 6 months

Question 3

chronic pain

Answer 3

often begins as acute pain
not dissipate after a min. 6 months
high anxiety, helplessness due to lack of medical treatment
interferes with daily life

Question 4

three sub categories of chronic pain

Answer 4

recurrent acute
intractable-benign
progressive

Question 5

recurrent acute

Answer 5

cause by benign or harmless condition

repeated intense episodes separated by period w/out pain

Question 6

intractable-benign

Answer 6

benign but persistent pain

crying levels of intensity, but never disappears

Question 7

Progressive

Answer 7

pain often originates from malignant condition
continuing pain and discomfort
Pain worsens over time, as underlying condition worsens

Question 8

what is pain mediated by

Answer 8

mediated by nociceptors

Question 9

theories of pain

Answer 9

specificity theory
pattern theory
the gate control theory

Question 10

specificity theory

Answer 10

separate sensory system for perceiving pain
specific sensory receptors for detecting pain stimuli
specific peripheral nerves and pathway to the brain
specific area within the brain for processing pain signals

Question 11

pattern theory

Answer 11

no separate system for perceiving pain
pain results from the pattern or type of stimulation received by nerve endings
intensity of the stimulation is key determination of pain
strong and mild stimuli of the same sense modality produce different patterns of neural activity

Question 12

limitations of ST

Answer 12

incorrect - no specific receptor cells in the body that only transfer information about pain

Question 13

limitations of PT

Answer 13

• requires stimuli triggering pain must be intense
• pain can be experienced without tissue damage
• tissue damage can exist without pain
• both fail to account for the important role of psychology in the perception of pain

Question 14

Gate Control Theory

Answer 14

• Psychological factors AND physiological factors
• Explains why the same event can be interpreted by different people as more or less painful
• Explains why sometimes pain is not experienced immediately
• Describes the individual as having some control over the experience of pain

Question 15

three different methods on the assessment of pain

Answer 15

physiological
self-report
behavioural
USE OF 2 OR MORE TECHNIQUES ADVISED

Question 16

Physiological

Answer 16

• Assume pain perception is associated with specific physiological responses
• R’ship between physiological responses and experience
of pain not consistent
• Limited use

Question 17

self-report measures

Answer 17

patient asked to describe their pain
interview
pain rating scales and diaries
pain questionnaires

Question 18

interview

Answer 18

useful for treating chronic patients

focuses on history of pain problem emotional adjustment etc.

Question 19

Pain rating scales and diaries

Answer 19

Useful for measuring how strong the pain is (intensity) and provides repeated ratings

Question 20

three types of pain scale

Answer 20

visual analogue scale
box scale
verbal rating scale

Question 21

Limitations to self-report

Answer 21

often require fairly high levels of verbal skills
less useful for children
misrepresentation of pain can occur, over/under exaggeration

Question 22

Behavioral assessment

Answer 22

• Observing behaviour
• Procedures for assessing pain in 2 types situations
• useful, but again open misrepresentation

Question 23

psychological methods

Answer 23

– biofeedback
– relaxation and distraction
– cognitive methods
– behaviour therapy (operant approach) – hypnosis

Question 24

biofeedback

Answer 24

• Monitor & change selected physiological functions (heart rate, muscle activity)
• Pts asked to engage in different thoughts/ behaviours to influence physiological response
• Over time, pt learns how to selectively “let go” of tension (e.g. in muscle) by change in behaviour
• Useful for headache, chronic back pain (but drawbacks)

Question 25

Cognitive methods

Answer 25

• Understanding how thoughts/ feelings influence the experience of pain
• Help people change perceptions of, reactions to, pain
• Information,  perceived control over pain (e.g. childbirth programs)
• Cognitive re-definition - re-label the pain (e.g. childbirth)
• Effective in  variety types pain (headache, back-pain)

Question 26

Hypnosis

Answer 26

• Relieves pain only in individuals who can successfully undergo deeply hypnosis
• Provides a high degree of analgesia (minority of pts)
• Cognitive and behavioural techniques generally > effective